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Schiavo
Case Raises Medical Ethics Questions |
Posted:
03.28.05
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After almost two weeks without a feeding tube, Terri Schiavo
is getting closer to death. Her parents argue that their daughter
is being cruelly starved to death, a claim disputed by some doctors
who say patients in Schiavo's state have no knowledge of "starvation."
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Terri Schiavo, now 41 years old, suffered heart failure in 1990
due to a chemical imbalance from the eating disorder bulimia.
She lies in a Florida health center with brain damage that makes
her unable to speak or care for herself.
Schiavo's husband contends that Terri would not have wanted to
live in such a limited way, while her parents say that removing
her life-sustaining feeding tube is a cruel death of starvation
and dehydration.
 Whether
Schiavo is suffering because of the lack of food and water has
become a contentious issue.
Many doctors familiar with the Schiavo case and other cases of
people in a "persistent vegetative state" as courts
have stated Schiavo to be in, say that what is happening to Schiavo
is not starvation in the sense that most people think of it.
"Patients in a persistent vegetative state give no sign
of experiencing pain and suffering in any way that we can relate
to," Dr. Russell Portenoy, a neurologist and chairman of
the Department of Pain Medicine and Palliative Care at Beth Israel
Medical Center in New York, told the NewsHour.
Her parents, who earlier released video suggesting that Terri
is able to react to her surroundings, disagree.
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The feeding
tube |
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For people like Schiavo, in a state of little to no consciousness
due to brain damage, feeding tubes that funnel nutrition directly
into the stomach are the only means of sustenance.
While there are different kinds of feeding devices, the one that
Schiavo has -- a gastrostomy tube -- uses a small hollow catheter,
or tube, to provide nutrition and hydration in the form of liquid
food, fluids and medication. The tube is inserted by cutting a
small hole in the patient's abdomen, guiding it through into the
stomach and then stitching up the hole around the tube to prevent
shifting.
Schiavo has been kept alive by this means of life support since
1990 when she suffered heart failure from complications of the
eating disorder bulimia and fell unconscious.
 Lack
of oxygen caused damage to the parts of the brain that controlled
thinking, emotion and memory, despite images released by her family
showing Schiavo appearing to smile and react to stimulation.
People in Schiavo's state "have no knowledge of food,"
according to Dr. Sean Morrison of Mount Sinai School of Medicine
in New York.
"They don't recognize food," Morrison told The New
York Times. "If you put food in their mouth, it would sit
there until they took a breath, and then that food would go down
into the lungs."
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Is she suffering? |
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Schiavo's parents, Bob and Mary Schindler, say their daughter
is being allowed to slowly and painstakingly starve to death,
a violation of her civil rights.
Already, according to the Schindlers, Schiavo is showing signs
of dehydration. Her lips are dry, her skin is flaking, her eyes
are sunken and her breathing is strained.
 "Terri
is weakening. She's down to her last hours. Something has to be
done, and has to be done quick," Bob Schindler said on March
18.
Without the feeding tube, Schiavo could die within days. Her
organs would slowly shut down, toxins would build up in her system,
she would fall into a coma and her heart would eventually stop.
"Typically patients who are toward the end of life and do
not have access to nutrition or hydration slowly get quieter and
sleepier; they lapse into coma. The coma gradually deepens and
then finally they die," Portenoy said.
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Language plays a role in arguments
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Language has played a large role in the Schiavo story, according
to Dr. Kathleen Jamieson, director of the Annenberg Public Policy
Center at the University of Pennsylvania.
 People
in favor of reinserting Schiavo's tube are using language "that
increases your perception of her as a sentient human being, whose
capacity to tell you that she wants to stay alive is limited only
by the fact that she lacks the capacity to speak," Jamieson
told The New York Times.
On the other hand, those who argue that Schiavo should be allowed
to die say "that the person who was there is no longer there."
--
Compiled by Kristina Nwazota, Online NewsHour Extra
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